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You’re Never Alone: Tech Tyranny and Digital Despots – June 17

Bodies, brains, and health tracking in the digital age.

Two weeks ago, we looked at the newly announced Pokémon Sleep, a gaming device that, placed on your bed, will monitor your sleeping hours – the amount of physiological data to be collected remains unknown, but could biological tracking and health care be the next major trend in personal electronics? Wearables like the Fitbit and the Apple Watch (with its health app) are old news in the bodily tracking field – monitoring your heartbeat, your sleep stages, and physical movements. In 2017, Fitbit Inc. teamed up with insurance provider United Healthcare to create a program whereby people who wore the fitness tracking device could earn up to $1,500 in Health Savings Account or Health Reimbursement Account credits per year. But if people can be rewarded for the data collected, will there come a time when they can be penalized?

Alexa Learns Health Care Skills

Amazon, in particular, has been steaming ahead into the health care industry. In 2016, software development company Macadamian revealed that it was developing a range of health care applications for the Amazon Echo. It teamed up with Health Navigator, a company that develops digital health care, to create an Alexa skill that allows the home assistant to triage users’ health concerns. The user supplies his or her symptoms, and Alexa recommends further action. Amazon has also partnered with the U.K.’s National Health Service to provide individually tailored health information.

Now, Alexa’s health care abilities have expanded significantly. In April, Amazon launched a series of skills in partnership with third-party providers to allow their customers to book medical appointments, deal with prescription orders, locate medical centers, check blood sugar levels, share children’s postoperative recovery information, and manage personalized “health improvement goals” or “Health Nudges.” These were developed with six health care providers that operate in line with the U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA), a law that mandates medical privacy, to help expand Alexa’s capabilities into dealing with users’ personal medical information.

While the services may be highly convenient and offer many benefits to those dealing with health issues, one wonders how a database of personal information could affect future services, insurance rates, or advertising. Amazon is already expanding into other areas of health care, having begun to sell specialized medical equipment and cooperate with the U.S. National Institutes of Health to develop cloud computing services for biomedical researchers. In 2018, it also made the $1 billion purchase of online pharmacy PillPack. Amazon’s entry into the health market has brought predictions that it will help to lower costs, but how long will that last? With Amazon aiming to become a major supplier to hospitals, a medicine vendor to the public, a developer of computing software for the government and insurance companies, and to create a database of the public’s overall physical health, it will come to control a huge portion of the industry. What kind of advice will Alexa end up giving? Surely it will be designed to benefit the corporation and not the patient.

Alexa Patent Seeks to Determine Your Mental Health & Advertise To You

In October, it was revealed by The Telegraph that Amazon had a patent approved for technology that would automatically detect whether a user was sick by simply analyzing his or her speech and non-verbal cues. The device would then suggest – in what appears to be a thinly-veiled form of advertising – possible remedies. For example, if a person coughs and sniffles while talking to the device, Alexa might offer to order some throat lozenges – no doubt purchased from an Amazon-owned online pharmacy.

The patent, filed as “Voice-Based Determination of Physical and Emotional Characteristics of Users,” would also detect a user’s demographic information (age, gender, regional accent), as well as their location (by analyzing background noise), and emotional state. For example, a crying person would be classed as experiencing “emotional abnormality.” Alexa could also analyze a person’s tone of voice to discover their mental state, e.g., bored or tired – and then, the patent says, an advertiser could pay to have a product specifically marketed to people experiencing a certain emotional state.

Amazon is not the only company working on getting inside your head; in April, Cogito Corporation, a company that uses artificial intelligence to analyze phone conversations for sales purposes, was awarded a patent “for identifying human emotions and/or mental health states based on analyses of audio inputs and/or behavioral data collected from computing devices.”

DNA Analysis and You

If data is collected on our physical and mental health, what about information on the very building blocks of life? The popularity of DNA genealogy testing has enlightened many about their ethnic heritage and family background, but the mass collection of genetic information has also brought about concerns over privacy and biological profiling. A Harvard Law School panel met in May to discuss gene-testing services like AncestryDNA and 23andMe.

The Petrie Flom Conference webpage asks:

“In an age where serial killers are caught because their relatives chose to submit DNA to a consumer genealogy database, is genetic privacy for individuals possible? Does the aggregation of data from genetic testing turn people into products by commercializing their data? How might this data reduce or exacerbate already significant health care disparities? How can we prepare for widespread access to genetic editing tools?”

A report by the Daily Mail adds, “The panel questioned how the public would react, for example, if hearing that a candidate has genes linked to risk-taking or schizophrenia, even though having a gene for a condition doesn’t necessarily mean you will develop it.” It turns out, DNA can indicate not only our potential health hazards but our success in modern society. A 2018 study found that academic achievement was linked to DNA markers. According to one of the geneticists involved in the research, Saskia Selzam, scientists can use a person’s DNA to create a “polygenic score,” which predicts life outcomes and personal traits:

“There have been some very exciting advances happening in molecular genetics research that allow us individual predictions based on someone’s DNA … based on these polygenic scores, we can actually predict 10% of why individuals differ in their educational achievement at age 16 … this is actually a very large effect size. So, imagine for example, gender differences that are often thought to create massive differences between individuals. They only account for around 1% of why individuals differ in educational achievement.”

Selzam says that a difference of an entire exam grade could be predicted according to DNA markers, as well as whether a student would go on to undertake higher education. She suggested that genetic data could be used for early intervention with people who are likely to suffer from learning disabilities.

Final Thoughts

Fitbits, fitness apps, and DNA tests may all be able to give us fascinating and useful information about ourselves and our health. But have many paused to consider how the data being collected now about our bodies will affect us later? As every individual gradually becomes a product to be recorded, profiled, and sold (as well as sold to), our physical and mental health, and even our very genetic code, may become instruments in the corporate toolbox.

That’s all for this week from You’re Not Alone. Check back in next Monday to find out what’s happening in the digital realm and how it impacts you.

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